Coding Consultant Educator - Flexible Schedule - Remote Job Opportunity

CODING CONSULTANT EDUCATOR Flexible Schedule Remote Job Opportunity

When you join the SMH team, you are aligning yourself with an organization whose values drive our quality care in our community for the past 60 years. SMH has an exciting opportunity for a Coding Consultant Educator to join our team. The ideal candidate has extensive knowledge of coding with experience in auditing, education and training of medical coders and Clinical Documentation Integrity Specialist (CDIS).

POSITION SUMMARY:

The Coding Consultant Educator leads, manages and participates in documentation compliance, coding and clinical documentation integrity related projects, including specialty specific coding and compliance education, audits, research, and financial analysis. Ensures quality of all processes surrounding the revenue cycle as they pertain to health information functions. Ensures coding and documentation regulatory compliance with CMS and JCAHO. Provides education to Coders, CDIS, HIM Specialist and Providers to improve documentation and query assignment, develop education based on industry performance, regulatory focus areas and observed opportunities.

KEY RESPONSIBILITIES:

• Responsible for staffing, organizing and directing the Coder and CDIS team. Oversees Monitors workflow, productivity and quality of coding and abstracting functions including DRG and APC Coding, abstracting and documentation integrity.






• Plans and prioritizes the work of the coding and clinical documentation improvement staff. Coordinates scheduling of Coders and CDIS, maintaining appropriate staffing levels with minimum use of overtime or contract services.






• Ensure accurate code assignment, develops methods to provide oversight and ongoing compliance, educates staff on coding/documentation updates and opportunities, and assists HIM Management team in all functions in relation to coding, CDI, and HIM compliance.






• Utilizes comprehensive knowledge of ICD-10 and CPT/HCPCS coding guidelines and clinical knowledge to educate Coders, CDIS and HIM Specialists to provide best practice principals.






• Collaborates and keeps abreast daily by monitoring the DNFB and DNFC to an acceptable level. Monitors, evaluates and reports on functions related to reimbursement. Responds to inquiries related to these functions. Takes corrective action when needed.






• Assists with development of policies and procedures for coding and clinical documentation integrity functions and monitors staff compliance with policy and procedures.






• Performs internal audits to ensure integrity of coding and clinical documentation. Observe, create and execute education opportunities for improvement of HIM staff based on audit results.






• Performs onboarding/training of new hires. Performs training of new Coders. Provides and executes professional development career advancement program for coding specialists.






• Creates personal development action plans for Coders and CDIS, providing for job enrichment and professional growth.






• Collaborates with HIM leadership to supervise, coach, evaluate and counsel employees to ensure competency of job duties, including regulatory compliance with CMS, JCAHO and other regulatory bodies.






• Coordinates outside vendor coding and CDI quality audits.






• Recognizes opportunities for documentation improvement using strong critical-thinking skills. Uses critical thinking and sound judgement in decision-making, regularly ensuring compliance and appropriate documentation and coding capture according to coding guidelines.






• If workload demands, assist with coding and CDI workload.






• Monitors and report progress and achievement of HIM department goals and objectives.






• Collaborates with other departments on documentation requirements to ensure revenue cycle compliance.






• Evaluates opportunities for HIM department process improvement, workflow enhancements efficiencies.






• Facilitates communication between CDIS and Coding. Coordinates reconciliations of DRG discrepancies in the spirit of education.






• Assists hospital Medical Auditor to defend payer denials by providing record review to ensure compliance and provide guidelines to support actions. Educate HIM and Medical Staff on findings.






• Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.






• Represents the HIM department at hospital meetings and activities as needed.






• Performs other duties as assigned or directed to ensure smooth operation of the organization.






• Meets organizational expectations as defined by the Employee Standards of Performance, hospital and department policies and procedures, and the hospital's strategic goals.

  
  
  

  The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

  
  
  

  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:












• Demonstrates strong leadership, interpersonal, teaching, analytical and operational problem solving skills.






• Ability to use standard desktop and windows based computer system, including basic understanding of email, internet, and computer navigation.






• Effective verbal and written communication skills and the ability to present information clearly and professionally.






• Extensive comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping.






• Ability to prepare and present findings and results to diverse audiences.






• Ability to plan, coordinate and execute complex HIM projects.






• Time management skills, including the ability to prioritize, organize and coordinate multiple work areas and assignments under fast paced and changing conditions to meet deadlines.






• Ability to resolve issues and understanding when to escalate or change priorities. Ability to balance technical and practical needs.










• Positive attitude and the ability to promote a cooperative and pleasant work environment since all responsibilities are team oriented.






• Experience utilizing encoding/grouping software and EMR systems.






• Ability to use standard desktop and windows based computer system, including basic understanding of email, internet, and computer navigation.






• High ethical standards.






• Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines.






• Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters.






• Knowledge of documentation regulations of Joint Commission and CMS.






• Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.






• Ability to organize and set priorities to ensure objectives are met in a timely manner.






• Ability to adapt to change and handle challenges proactively and with pose.






• Ability to effectively collaborate with physicians and managerial staff at all levels.

  
  
  

  EDUCATION/EXPERIENCE/LICENSURE:








• Education: Associate or Bachelor s degree in Health Information Management or related field required.






• Experience: Minimum five (5) years of current complex outpatient and inpatient coding required. Experience as or working with CDIS required. Education and/or auditing experience preferred.






• Certification/Licensure: One of the following certifications:

  
  
  

  Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC) from American Health Information Management Associations (AHIMA) or American Academy of Professional Coders (AAPC) required.

  
  
  

  AND

  
  
  

  Certified Documentation Improvement Practitioner (CDIP), Certified Clinical Documentation Specialists from American Health Information Management Associations (AHIMA) or American Academy of Professional Coders (AAPC) preferred.

  
  
  

  AND

  
  
  

  Registered Health Information Administrator (RHIA)/Technician (RHIT) certification preferred.

  
  
  

  *Additional degrees, business training experience and/or certifications may be combined to meet minimum qualifications.

  
  
  

  Benefits:








• 401(k)






• Dental insurance






• Health insurance






• Life insurance






• Paid time off






• Vision insurance

  
  
  

  Schedule:








• Monday to Friday

  
  
  

  License/Certification:








• Medical Coding Certification (Required)

  
  
  

  Work Location:








• Remote

  
  
  

  Position Perks:








• 100% remote work from home






• Flexible schedule






• Paid time for free CEU s






• Professional development






• Positive working environment






• Family friendly open door culture






• Working for a community based hospital